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Abstract
Background/context Fostering good first impressions of a care setting are an important component of building confidence and providing reassurance for patient’s, carers, relatives and visitors. The 15 Steps Challenge is a toolkit devised by the NHS Institute for Innovation and Improvement in 2012 to help staff, patients and others to identify improvements that enhance the patient experience and environment. Initially 15 Steps was developed for use in Hospital wards but we adapted it for the whole Hospice environment.
Aims To use an accredited quality improvement tool and clear framework to facilitate in depth observations of quality care across four domains:
Welcoming
Safe
Caring and Involvement
Well organised and calm
Approach used
Readily available easy to use literature to guide implementation
PowerPoint slides for awareness sessions and training
Small team to undertake the review (included 1 patient/carer representative, 1 non-clinical staff and 2 clinical staff)
Dedicated toolkit
Engagement with internal stakeholders
A structured walk around the entirety of the Hospice environment
Presentations to different staff groups on findings
Focus on positive feedback and sharing good practice
Repeated at 6 months to show achievements and improvements
Outcomes Explicit patient/carer perspectives were taken into account.
Detailed action plans with key positive impacts on the working environment.
Supports the Care Quality Commission’s Essential Standards
Case study for evaluation (IES) by telephone survey.
Application to Hospice Practice
Use of the 15 Steps toolkit clearly effective as a quality improvement initiative
Re-audit has shown improvements in all domains
Heightened staff awareness; quality is everyone’s business
Strengthened communication across services
Adaptable for use in Fundraising/Trading Company improving quality across the organisation.
The Challenge can be repeated on a regular basis to cover all areas and to ensure that improvements are being progressed and maintained.